The commissioning Big Picture has just become a little clearer. Because the Government’s Department of Let’s Make It Up As We Go Along has just fed us another gobbet of CCG information scribbled, as ever, on the back of an envelope.
Remember those ‘Quality Premium Payments’ which the Government promised to CCGs, provided we GPs negotiate a few minor obstacles, such as reducing healthcare related infections, slashing emergency admissions and pulling the NHS out of its financial Black Hole? The assumption was that CCGs would divvy this up between practices as a little reward for all the blood, sweat and tears expended in saving the health service while trying to avoid getting punched/sued/shafted along the way.
Not so. Apparently, CCGs must spend the money on improving patient services, not lining our pockets. Let’s ignore the obvious irony here, that we’re cutting services to save money to gain quality premiums to…er…improve services. Hopefully it’ll be just like the old fundholding days when ‘improving services’ had a broad definition and, if I recall correctly, included selling woks to punters suffering stir fry-deficiency. So we could use our premium dosh to employ, say, an asthma/COPD nurse to screw every QOF point possible out of patients, sorry, that is, to improve patient care?
Again, not so. The money may well be tied into local improvement programmes involving ‘targeted’ incentive schemes. In other words, we’ll be rewarded for hitting targets by being given more targets to hit.
So, going back to the Big Picture, I can’t decide whether it’s an Escher painting of us trudging around for eternity achieving nothing, or a Hieronymus Bosch vision of Hell. Either way, it doesn’t look good.
Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.
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